The program of research proposed for this FIRST Award is designed to develop better methods for the study of the role of alcohol in fatal injuries. The program seeks to establish a surveillance system for identification of alcohol-related injuries, determine factors associated with drowning in older children and adults, develop a methodology to study alcohol-related injuries and extend the use of the surveillance system and methodology to investigate occupational injuries. While alcohol is known to be a major risk factor for motor vehicle injuries, little is known of its involvement in other fatal injuries. Initial studies suggest a high degree of alcohol involvement in drownings, but no studies have documented its magnitude as a risk factor. 1. A computerized state-wide surveillance system for alcohol- related injuries will be established in the Office of the Chief Medical Examiner of Maryland. 2) All non-boating drownings in Maryland among persons over 10 years old in a three-year period will be studied. Detailed investigations, including the availability of alcohol, will be conducted to ascertain circumstances surrounding the drowning. 3) A case-control study of drownings will examine risk factors. In the course of the study different methodologies will be evaluated and a causal model for alcohol and injuries will be developed. 4) An analysis of occupational injury fatalities will be carried out utilizing the surveillance system and methods developed during the investigation of drownings. Despite widespread belief that alcohol use plays a significant role in occupational injury fatalities, limited studies to date have failed to demonstrate an important association. Following these studies, the information collected will be used to suggest appropriate interventions for reduction of drownings and improved methods for investigating the role of alcohol in injury fatalities.